The focus of this blog is on the wonders of government-run health-care everywhere but I also note the damage done to private medicine by a legal system that supports predatory litigation.

The long-established socialized medicine systems in Britain and Australia are a particularly relevant warning about where such systems end up.

Posts by John J. Ray (M.A.; Ph.D.)

Friday, June 12, 2009

British mother forced to deliver her own baby on motorway... after hospital turned her away for 'not being ready'

A new mother gave birth in a car as it sped along a motorway after being sent home twice that day by a hospital because she wasn't ready enough. Rebecca Longley, 20, was forced to deliver daughter Aaliyah herself as boyfriend Andrew Mildenhall desperately tried to stay focused on the road ahead. The couple had first gone to the hospital that morning and then again in the evening but were told both times that Rebecca wasn't ready to give birth.

Two hours later the beauty therapist's waters broke but when she phoned the same hospital, medics advised her to stay at home. Just ten minutes later Rebecca and Andrew decided to take matters into their own hands and head back to the Royal Hampshire County Hospital, in Winchester, Hants. But before they got there Rebecca went into labour and gave birth to the 6lb 1oz baby girl on the front passenger seat on the M3 motorway.

The couple have now called on the hospital to review its admissions procedures. Miss Longley, from Hamble, Hampshire, said: 'I really had no idea what to expect because it was my first child. I had a real mix of emotions.

'When it first started I was so scared and worried but that turned to relief and happiness when she was born and we realised she was OK. 'Andrew did a brilliant job to carry on driving even though he was feeling quite faint. 'I had no drugs and I was screaming with pain but my natural instincts kicked in as soon as I saw the baby's head pop out. I just knew what I had to do.'

Miss Longley and Mr Midenhall first visited the Royal Hampshire County Hospital at 7am but were turned away. They tried again at 8pm but were met with the same response. Two hours later Rebecca phoned the hospital's maternity ward and said that her waters had broken - but she was told to stay at home.

Baby Aaliyah ended up making her entrance just before 10.30pm in Mr Midenhall's Peugeot 206 car. Miss Longley added: 'We have been so lucky because Aaliyah is a healthy baby. 'But if there had been complications like if she had had the umbilical cord wrapped around her neck then I dread to think what could have happened. 'We hope the hospital reviews its procedures especially with first time parents. 'If I had stayed in on the second visit then I would have given birth two hours later in a safe environment.'

Carpenter Mr Midenhall added: 'She appeared so quickly so there was no time to pull over and stop - I just kept driving. 'It was such a relief when I heard her crying because I knew she was going to be alright.'

A hospital spokesman confirmed that Rebecca was sent home twice but said that the advice was given because of the slow progress of her labour. He added: 'Labour is different for every woman. We would describe Rebecca's labour as totally natural, albeit rapid once it had begun.'

Amid the economic downturn and slow growth for retail and outpatient medical care services, pharmacy giants Walgreen and CVS are rolling out new specialized services at their in-store clinics, going beyond treatment of routine maladies. Launched over the last four years to care for such simple ailments as ear and sinus infections, strep throat or pinkeye, retail clinic operators now are training nurses to do specialized injections for such chronic conditions as osteoporosis and asthma, the LA Times reports.

In addition, they are offering treatments for advanced skin conditions that include removal of warts and skin tags or closing minor wounds. Care for minor "sprains and strains" also is being offered at some retailers, and pilot projects are underway for breathing treatments and special infusions of drugs derived from biotechnology. "We want to create a health corner — a real center that looks like you are walking into the doctor's office," Walgreen chief executive Greg Wasson said of the retailer's Take Care brand clinics, reports Chicago Tribune writer Bruce Japsen for the Times.

There is a business reason for adding services: Walgreens and CVS have slowed their expansion of clinics and are instead making attempts to boost revenue by adding new lines of business in their clinics. Typically staffed by advanced-degree nurses known as practitioners, most of the nation's more than 1,100 retail health clinics are open seven days a week, with no appointment needed. The model has been greeted by health insurers, employers and consumer groups as one way to address the rising number of uninsured Americans, estimated at more than 46 million.

Retail clinics not only market themselves as a convenience, they also can be less expensive, providing a competitive threat to primary-care doctors and even specialists. Costs for services for those paying out of pocket at retail clinics generally run $55 to $75 compared with $100 or more for a visit to a primary-care physician.

The physician community says consumers should look at the added services by clinics with skepticism, particularly when it comes to care for chronic ailments. And doctors say what a consumer may see as routine may turn out to be something worse. "A sprain could be a muscle tear or a break, for crying out loud, so how does a [retail] clinic know when the patient comes in that they are going to treat a sprain?" said Dr. James Milam, president of the Illinois State Medical Society. "When my nurse gives an injection, I am here. The patient needs a regular doctor who has a history with the patient, knows their history, their family history and their illnesses," he added, the Times reports.

But retailers say they are not going beyond "scope of practice" laws that regulate what nurse practitioners can and cannot do. The clinics are under physicians' supervision, though doctors usually are not on site. "These are new services we were not providing that our customers asked us to provide," said Chip Phillips, president of MinuteClinic, a CVS subsidiary. "We are slowly and gradually expanding our services," he told the Times.

A DAMNING report has cast grave doubts over the credibility of the state's $6 billion hospital building program and exposed poor planning for the state's future health needs.

Auditor-General Glen Poole has revealed that planning surrounding the $100 million Townsville Hospital expansion was so inadequate that Queensland Health itself was concerned the result would be "dysfunctional" on an operational basis. Mr Poole identified a system which had no clear links between the health service plans drawn up by Queensland Health and the funding decisions the Government subsequently made.

His report follows a wave of controversy over the Government's decision to establish a $1.1 billion Queensland Children's Hospital near the Mater Hospital at South Brisbane, a move critics insist was done without adequate planning.

The Government's hospital infrastructure program, which it boasts is the biggest in Australia, also includes the $1.5 billion Gold Coast University Hospital, due to open in 2012, and the $1.2 billion Sunshine Coast Hospital, expected to open its doors in 2014.

Health Minister Paul Lucas admitted the Government had made health commitments before the proper planning had been undertaken. "I think that in the past what has happened is that there has been public pressure for something to happen, then an announcement is made and then off we go," Mr Lucas said.

Mr Poole said a case in point was the Townsville Hospital project, which the department admitted was announced three years ago without any supporting health services or capital infrastructure plan. The project was supposed to deliver 100 extra beds and double the hospital's emergency department by next year but Mr Poole's report reveals that nothing has been budgeted for the expansion of other parts of the hospital such as pharmacy and record-keeping services to cope with the extra load.

A business case for the entire project – which Queensland Health neglected to draw up until February this year – warned that unless more funding was found, the project would establish "a service that will be dysfunctional".

Queensland Health director-general Mick Reid admitted the report meant Queensland Health may have put services in the wrong place or provided infrastructure without recurrent funding to operate them. He said while the report exposed serious issues, it also highlighted how the department had already recognised these and taken action. "I think it is a fair cop that the department is criticised for its poor service planning functions," he said.

Mr Poole's report is yet another blow to Queensland Health, whose operations have been under intense scrutiny since the 2005 Bundaberg Base Hospital scandal. "I expected that with a focus on service planning since 2005, the department would have more advanced service planning systems in place," the report said. "Funding and resourcing implications were not identified in most plans reviewed."

1 comment:

Just came across your blog because I don't see why americans are so scared of socialised medicine. Remember every body living in Britain is free to buy expensive private health insurance if they want, just as you guys do in the USA. So we don't have to use national health care if we don't want to, but who wants to pay the money you guys do when for the most part the system works for the average joe. The story you posted about the girl giving birth on the motorway is NOT a typical experience and is not due to socialized healthcare - it's a random freak event, and yes some silly midwife made a mistake, it's not because it's government run. I've had 3 kids there and have lived there most of my life and had great health care with no worry of crazy bills and fyi it's paid for out of our national insurance contributions - the equivalent of your social security payments. I was surprised to learn that an american pays about 8% in social security taxes and it's the same in the UK so we are no worse off financially for having the system. We've just moved back to the USA (my husband is from here) with no healthcare coverage with his job...it sucks!!!!!!!!!! At least there I didn't have to stress about getting sick like I do here.

Background

Postings from Brisbane, Australia by John Ray (M.A.; Ph.D.) -- former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party.

This blog gives a lot of attention to events in Australia and Britain -- places where there already exist systems similar to the one most likely to befall the USA if the Democrats get their way -- "Free" medical care supposedly available to all through government hospitals but with a competing private sector as well. The Canadian system is considered too Soviet to provide a likely model for the USA

TERMINOLOGY: Many of my posts concern the very instructive state of socialized medicine in Australia. Like the USA, Germany and India, Australia has a system of State governments which have substantial independence from the central (Federal) government and it is they who are mainly responsible for "free" health services. It may therefore be useful to some for me to note the standard abbreviations for the States concerned: QLD (Queensland), NSW (New South Wales), WA (Western Australia), VIC (Victoria), TAS (Tasmania), SA (South Australia).

For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Conservatives do NOT object to helping the poor. Government welfare legislation in aid of the poor was in fact first introduced by conservatives -- Bismarck and Disraeli in the 19th century. What conservatives want is for the help to be delivered in a sane manner. And anyone who thinks that government bureaucracies can run hospitals well is completely out of touch with reality.

One of the oldest "free" public hospital systems in the world is that in the Australian State where I live: Queensland. It dates from 1944 (Britain's NHS began in 1948). So its advanced state of decay reveals well where the slow cancer of bureaucracy ends up. It now has three "administrative" employees for every medical employee. All those clerks are really good at curing people, I guess! Frequent bulletins on the flailing but ineffectual attempts to "fix" the system will appear here -- as well as bulletins on the dreadful things it does to patients and the long waits they endure.

On all my blogs, I express my view of what is important primarily by the readings that I select for posting. I do however on occasions add personal comments in italicized form at the beginning of an article.

I am rather pleased to report that I am a lifelong conservative. Out of intellectual curiosity, I did in my youth join organizations from right across the political spectrum so I am certainly not closed-minded and am very familiar with the full spectrum of political thinking. Nonetheless, I did not have to undergo the lurch from Left to Right that so many people undergo. At age 13 I used my pocket-money to subscribe to the "Reader's Digest" -- the main conservative organ available in small town Australia of the 1950s. I have learnt much since but am pleased and amused to note that history has since confirmed most of what I thought at that early age.

I imagine that the the RD is still sending mailouts to my 1950s address!

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